Zellner Alberto Alfieri, Wirtz Dieter Christian, Schildberg Frank Alexander
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Bonn, Deutschland.
Z Orthop Unfall. 2025 Jun;163(3):250-264. doi: 10.1055/a-2436-7394. Epub 2025 Jan 20.
Formation of biofilms by bacteria is a major challenge in a clinical setting. The importance of these biofilms increases in specialties where foreign bodies and prosthetic material are used. Orthopaedics is such a speciality and phage therapy could offer additional therapeutic options when dealing with biofilm infections.We conducted a systematic literature review using the PubMed database. We searched for phage activity against biofilms of the most common pathogens found in orthopaedics.The results of the systematic review were broken down into different categories and discussed accordingly. We concentrated on the time the biofilms were allowed to mature, and the surface they were grown on. In addition, we checked the efficacy of bacteriophages compared to antibiotics and when applied simultaneously with antibiotics. We also investigated the source of the phages, how they were tested for sensibility against the biofilms, as well the conditions (pH, temperature) under which they remained active and stable.The data suggests that the in vitro efficacy of phages does not change under a wide spectrum of temperature and pH. To further explore the use of bacteriophages in orthopaedics, we need further studies that test biofilms which matured for several weeks on surfaces that are common in arthroplasty and traumatology.
细菌形成生物膜是临床环境中的一项重大挑战。在使用异物和假体材料的专科领域,这些生物膜的重要性日益增加。骨科就是这样一个专科领域,在处理生物膜感染时,噬菌体疗法可以提供额外的治疗选择。我们使用PubMed数据库进行了系统的文献综述。我们搜索了针对骨科中最常见病原体生物膜的噬菌体活性。系统综述的结果被分为不同类别并进行了相应讨论。我们重点关注生物膜成熟的时间以及它们生长的表面。此外,我们检查了噬菌体与抗生素相比的疗效,以及与抗生素同时应用时的疗效。我们还研究了噬菌体的来源、它们针对生物膜的敏感性测试方法,以及它们保持活性和稳定性的条件(pH值、温度)。数据表明,在广泛的温度和pH值范围内,噬菌体的体外疗效不会改变。为了进一步探索噬菌体在骨科中的应用,我们需要进一步的研究,以测试在关节置换术和创伤学中常见表面上成熟数周的生物膜。